ABSTRACT
Objective: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) has been shown to be effective for reducing symptoms of anxiety and depression in adolescents with emotional disorders. The present study aims to assess the effectiveness of internet-based UP-A in reducing stress, anxiety, and depression, and psychological flexibility of adolescents with subclinical features of emotional disorder during the COVID-19 pandemic. Methods: : This is a longitudinal randomized clinical trial conducted on 40 adolescents aged 12-17 years with subclinical features of emotional disorder. They were assigned randomly into two groups of intervention (n=20) and control (n=20). They first completed the Depression Anxiety Stress Scale- 21 item (DASS-21) and the Acceptance and Action Questionnaire (AAQ-2) online. Then, the intervention group received 12 sessions of UP-A through video call on WhatsApp, two days per week each for 45 minutes. The control group received no treatment. Immediately and 3 months after the intervention, the questionnaires were completed again. Collected data were analyzed using longitudinal marginal modeling. Results: : The stress, anxiety, and depression levels of adolescents decreased and their psychological flexibility increased immediately and 3 months after the intervention. The marginal modeling showed the interaction effect of time and group (p<0.05), indicating that the difference between groups was significant at all three time points. Conclusion: Online transdiagnostic therapy based on the UP-A is effective in reducing the symptoms of anxiety, depression, stress, and improving psychological flexibility of adolescents during the COVID-19 pandemic.
ABSTRACT
OBJECTIVE: Bipolar Disorder (BD) is one of the most common mental disorders associated with depressive symptoms and impairment in executive functions such as response inhibition. This study aimed to investigate the effectiveness of medication therapy combined with Transcranial Direct Current Stimulation (tDCS) on depression and response inhibition of patients with BD. METHOD: This is a double-blinded randomized clinical trial with pretest, posttest, and follow-up design. Participants were 30 patients with BD randomly assigned to two groups of Medication+tDCS (n = 15, receiving medications plus tDCS with 2 mA intensity over dorsolateral prefrontal cortex for 10 days, two sessions per day each for 20 min) and Medication (n = 15, receiving mood stabilizers including 2-5 tables of 300 mg (mg) lithium, 200 mg sodium valproate, and 200 mg carbamazepine two times per day). Pretest, posttest and 3-month follow-up assessments were the 21-item Hamilton Depression Rating Scale (HDRS) and a Go/No-Go test. Collected data were analyzed in SPSS v.20 software. RESULTS: The mean HDRS score in both groups was reduced after both interventional techniques, where the group received combined therapy showed more reduction (P < 0.01), although their effects were not maintained after 3 months. In examining response inhibition variable, only the combined therapy could reduce the commission error of patients under a go/no-go task (p < 0.05), but its effect was not maintained after 3 months. There was no significant difference in the group received medication therapy alone. CONCLUSION: Medication in combination with tDCS can reduce the depressive symptoms and improve the response inhibition ability of people with BD. TRIAL REGISTRATION: This study was registred by Iranian Registry of Clinical Trials (Parallel, ID: IRCT20191229045931N1 , Registration date: 24/08/2020).